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(The New York Times)   Lead Shrink on D.S.M. 4 says, "D.S.M. 5 promises to be a disaster that will medicalize normality, introduce Har Har Finks"   (nytimes.com) divider line 178
    More: Scary, Diagnosing the D.S.M., D.S.M., antipsychotic medications, Statistical Manual of Mental Disorders, American Psychiatric Association, Medical prescription, clinical practice, primary care doctors  
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13412 clicks; posted to Main » on 13 May 2012 at 6:49 PM   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-05-14 01:27:15 AM
omeganuepsilon: meddleRPI: Well, tell the lab rat that there are plenty of rats in the wild that *don't* get an electric shock when they eat the cheese.

I'm sure that will convince it to keep trying to eat the cheese.

Animals are allowed to be prejudice, it is a defense mechanism. Lab rats have no concept of logic, such as we do at any rate, it is beyond their very limited understanding(and yours apparently).

We humans are apparently trying to weed it out in the name of logic, if not "morals and ethics". Intellectual honesty requires the distinction.


You're right. Humanity has no need for defense mechanisms!

Regardless, the mean means nothing when you find yourself in the tail distribution. I'm not defending prejudice, but let's not completely discount the value of personal experience. We lead personal, not statistical lives. Where prejudicial arguments get lost is the fact that people are capable of better resolution than we give them credit for.

If I get robbed three times by a person, of whatever race, that acts, dresses, and behaves a certain way, I'm going to avoid that kind of person. I don't care what the data say. If I come across a person of the same race, but they act/dress/behave differently, then I'm not going to treat them like a robber.
 
2012-05-14 01:34:46 AM
Also some people are apparently just fine with being sociopaths, do your research.
 
2012-05-14 01:43:02 AM
Psychology is pseudoscience, pure and simple. It needs to be discredited and shoved in the dustbin of history.


Neuroscience... that has some potential.
 
2012-05-14 01:47:14 AM
clyph: Neuroscience

You make valid point. Do we treat a broken arm differently if it was broken while playing soccer vs. falling down the stairs? No. So as neuroscience evolves we will treat brain issues as they are, not just based on what caused them. Imbalances in the brain chemistry are what they are, no matter the cause. The sooner we start treating what matters and not what doesn't the better.

\Also the sooner we stop stigmatizing brain "injuries" and treat depression and other disorders like broken arms, the better.
 
2012-05-14 02:04:38 AM
AliceBToklasLives: I was once told that pretty much everyone in prison has Antisocial Personality Disorder. This was said with a straight face by a mental health professional.

www.reece-eu.net
 
2012-05-14 02:09:03 AM
Human Personality Disorder

A pervasive pattern of being a human, walking around, thinking about stuff, eating, wearing clothes except in the shower usually, sometimes having coffee in the mornings at that nice cafe up the street if not too late for work, that sort of thing, as indicated by one or more of the following:

(1) has a persistent habit of being alive

(2) is preoccupied with breathing, seeing and hearing things that are there

(3) believes that he or she is often awake and sometimes likes ice cream

4) requires oxygen or water

(5) has a sense of feeling sleepy at least once a day, often followed by long periods of sleep

(6) is interpersonally interactive, i.e., sometimes talks to other people, but not always

(7) lacks fire: is almost never consumed entirely by flames

(8) is often walking around, or maybe lying down on the couch

(9) shows behaviors

From The Diagnostic and Statistical Manual of Mental Disorders, Sixth Edition, 2026
 
2012-05-14 02:10:36 AM
Psychiatry *shouldn't* be about perfection.

It should be about confusion.

You want to give the patient drugs.

The drugs most likely won't work.

*however*
their condition can be treated *without* drugs

so give them the drugs. with side effects worse than the condition itself.
then the person will be encouraged to change so they don't have to take meds

worked for me.
 
2012-05-14 02:17:32 AM
clyph: Psychology is pseudoscience, pure and simple. It needs to be discredited and shoved in the dustbin of history.


Neuroscience... that has some potential.


And biological studies used to be called blasphemy and had to be carried out in secret.

It's a science, but it's in it's infancy. It's not fake(pseudo), it's limited.

What holds it back is humanity's decency. People like Pavlov are no longer allowed to do their tests.
Not saying it's wrong to stop him from farking up people, far from it, but it's a shame in a sense that knowledge is attainable, we just will not do it.

taurusowner: Do we treat a broken arm differently if it was broken while playing soccer vs. falling down the stairs? No.

But if there's a stab wound or a gunshot to the arm we do.

The brain and the psyche are the same way. May appear similar at a cursory glance, but there are minute differences in some cases, and different solutions may be required.

All in all it's a good analogy, but a flawed conclusion is drawn from it.

Different injuries, though similar, may require open surgery to remove fragments, or to implant a titanium plate, or repair torn flesh, or a simple set and cast. And that can be two different broken arms from a similar event.

Thing is, neuroscience is akin to complicated surgery, and psychology is akin to a simple setting of the bone in a clean break with almost no collateral damage. The sciences all intertwine in such ways, chemistry, biology, physics, psychology, psychology can all be useful sciences in treating and figuring out humans, and indeed, other creatures that qualify as sentient.

Just because it's not a complete sciences does not mean that we shouldn't use it. Even what you think of as "real" sciences are not "complete".
 
2012-05-14 02:20:21 AM
Jon iz teh kewl: Psychiatry *shouldn't* be about perfection.

It should be about confusion.

You want to give the patient drugs.

The drugs most likely won't work.

*however*
their condition can be treated *without* drugs

so give them the drugs. with side effects worse than the condition itself.
then the person will be encouraged to change so they don't have to take meds

worked for me.


Sometimes it's not really a disorder. I experienced every single diagnosable symptom of depression for about two and a half years, including suicidal thoughts. And then came home from Afghanistan and actually started dating and banging random chicks (call me a douche, whatever, I had never done it before) and all of a sudden my depression when away. Feelings of accomplishment and actually being liked by others did more to make me feel better about myself than any medication could have

People who feel like their lives suck and have no meaning aren't always depressed. Sometimes their lives really do suck and have no meaning. Fix that, you fix the "depression".
 
2012-05-14 02:27:38 AM
taurusowner: Jon iz teh kewl: Psychiatry *shouldn't* be about perfection.

It should be about confusion.

You want to give the patient drugs.

The drugs most likely won't work.

*however*
their condition can be treated *without* drugs

so give them the drugs. with side effects worse than the condition itself.
then the person will be encouraged to change so they don't have to take meds

worked for me.

Sometimes it's not really a disorder. I experienced every single diagnosable symptom of depression for about two and a half years, including suicidal thoughts. And then came home from Afghanistan and actually started dating and banging random chicks (call me a douche, whatever, I had never done it before) and all of a sudden my depression when away. Feelings of accomplishment and actually being liked by others did more to make me feel better about myself than any medication could have

People who feel like their lives suck and have no meaning aren't always depressed. Sometimes their lives really do suck and have no meaning. Fix that, you fix the "depression".


"banging random chicks"??

well i'd do that but i'd be called a rapist if i ever tried that.
 
2012-05-14 02:29:13 AM
HotIgneous Intruder: Maladaptive behavior. If you wonder if you're crazy you're sane and therefore not crazy.

But you may have an anxiety disorder.
 
2012-05-14 02:31:56 AM
BigLuca: PsiChick: Yeeeah, I think it was pretty obvious when 4 came out that the political infighting is really shooting the entire field in the foot.

BigLuca: Some changes ... "It is proposed that the eight symptoms of Oppositional Defiant Disorder should be divided into the following categories: Angry/Irritable Mood; Defiant/Headstrong Behavior; and Vindictiveness."

And do you know why they are changing that? Because fark you, that's why.

Same with Asperger's. The disorder has major and important differences from autism (especially that people with AS crave human contact\communication while autists may or may not), but why are they changing it? Because fark you, that's why.

This is not how you help people.

Yeah I heard about that and don't really understand it. They are just lumping it into Autism Spectrum Disorder. I don't know the back story, but it seems like it is more of a coding and billing deal. I sense politics afoot.


If you don't know, it's just bad reporting. The info was very easy to find here. Nothing to do with politics - it's a basic question of whether Aspergers really exists as a separate disorder, or if it's just high-functioning autism.

Currently, there's really only two differences between the Autism and Aspergers diagnostic criteria:
- Aspergers kids don't have language problems
- for a diagnosis of Autism, there must be symptoms before age 3.

That's pretty much it. Apart from the bits about onset and impairments in communication, the criteria are word-for-word identical.

The only empirical difference between people diagnosed as having Autism or Aspergers seems to be that those with Aspergers do better on verbal-IQ type tests (which is what you'd expect since by definition they are the group who don't have language problems). Having one vs the other doesn't tell the clinician anything about the cause, the appropriate treatment or probable outcome. Since it's not telling us anything useful, the diagnosis has no external validity - it honestly makes no sense to have two separate categories.

Part of the problem may be clinicians labelling all "high-functioning" cases as Aspergers because it's the new least-offensive label. But either way, the current label isn't telling us anything. So it makes more sense to put Aspergers back under autism, but make allowance for appropriate notes like "high-functioning" or "good language skills" or maybe even rank the severity of the impact on daily functioning.
 
2012-05-14 02:35:36 AM
IWood: Human Personality Disorder

While you have a point, people actually use that as an arguing point.

Philosophy and society in general want to create a "norm" for their own comfort. They strive to project what is and is not "right" into all sciences. Religions try to do this with creationists, but they're largely laughed out of the circle. It's not so easy to do that to "moral" and "ethical" beings though. They share many of the same attitudes and even opinions of the deeply religious, but do not have a ridiculous sky god to ridicule, and are reasonable in other areas, so it's harder to demonstrate their unwillingness to learn.

Just as an example that I remember reading about.

Some say it's a "disorder" to want to breed with a female as soon as she's able because of society's norms and code of behavior.

Evolutionary speaking though, it's a wise move. It increases the odds that the progeny will be yours. Same reason the honey-moon came about, to allow for sufficient time to ensure that no other male's seed was what caused the pregnancy. That drive in man is a fundamental urge to reproduce.

Sure, I'll agree the guy is a sociopath for not conforming to society even though society tells him it's wrong, but who's society to be making that call? It's a purely moral judgement.(which is why I don't buy into some uses of sociopath as a disorder, genetics and instinctual drives are not a democracy, can't even be controlled by the guy that owns them)

The drive itself is immoral, but not unnatural. Creatures throughout the animal kingdom do it, humans used to, and likely do still in some cultures where it's allowed.
 
2012-05-14 02:36:18 AM
Jon iz teh kewl: taurusowner: Jon iz teh kewl: Psychiatry *shouldn't* be about perfection.

It should be about confusion.

You want to give the patient drugs.

The drugs most likely won't work.

*however*
their condition can be treated *without* drugs

so give them the drugs. with side effects worse than the condition itself.
then the person will be encouraged to change so they don't have to take meds

worked for me.

Sometimes it's not really a disorder. I experienced every single diagnosable symptom of depression for about two and a half years, including suicidal thoughts. And then came home from Afghanistan and actually started dating and banging random chicks (call me a douche, whatever, I had never done it before) and all of a sudden my depression when away. Feelings of accomplishment and actually being liked by others did more to make me feel better about myself than any medication could have

People who feel like their lives suck and have no meaning aren't always depressed. Sometimes their lives really do suck and have no meaning. Fix that, you fix the "depression".

"banging random chicks"??

well i'd do that but i'd be called a rapist if i ever tried that.


Talk to female you're attracted to. See female 1-on-1 in social setting. End in coitus.

The same thing most guys do in high school and college but I had never done, and I'm 28. The lack of a social life and romantic validation played hell with my self-worth. I'm just now getting back on track, a good 10 years behind when most males do.
 
2012-05-14 02:58:21 AM
Old news is old

ecx.images-amazon.com
 
2012-05-14 02:59:59 AM
RE the babies on psychotropic drugs, this mythbuster report should make you feel better. By far the most common class was anti-anxiety tablets ... and GAO was classifying antihistamines as anti-anxiety drugs!

Sure, as a side-effect an antihistamine might make you feel a little relaxed and drowsy, but best guess is that they were trying to stop a runny nose, not dope the kid up!

Take away the 3,509 antihistamine scripts, you're left with 332 ... 271 of which were benzos (probably used to slow-detox baby after birth). Some of the rest are anti-convulsants.

All in all, very few questionable scripts.
 
2012-05-14 03:36:40 AM
taurusowner: Jon iz teh kewl: taurusowner: Jon iz teh kewl: Psychiatry *shouldn't* be about perfection.

It should be about confusion.

You want to give the patient drugs.

The drugs most likely won't work.

*however*
their condition can be treated *without* drugs

so give them the drugs. with side effects worse than the condition itself.
then the person will be encouraged to change so they don't have to take meds

worked for me.

Sometimes it's not really a disorder. I experienced every single diagnosable symptom of depression for about two and a half years, including suicidal thoughts. And then came home from Afghanistan and actually started dating and banging random chicks (call me a douche, whatever, I had never done it before) and all of a sudden my depression when away. Feelings of accomplishment and actually being liked by others did more to make me feel better about myself than any medication could have

People who feel like their lives suck and have no meaning aren't always depressed. Sometimes their lives really do suck and have no meaning. Fix that, you fix the "depression".

"banging random chicks"??

well i'd do that but i'd be called a rapist if i ever tried that.

Talk to female you're attracted to. See female 1-on-1 in social setting. End in coitus.

The same thing most guys do in high school and college but I had never done, and I'm 28. The lack of a social life and romantic validation played hell with my self-worth. I'm just now getting back on track, a good 10 years behind when most males do.


Pretty ghay.
I would have married the first one.
But that's just me.
 
2012-05-14 07:19:14 AM
NobleHam: Peer review and politics are the same thing, dummies.

My wife would hate to agree with you, but she would. Under her breath. With her back turned. She's been on the receiving end of someone trying to protect their previous findings that she found evidence against using more in-depth procedure.
 
2012-05-14 08:11:04 AM
omeganuepsilon: PonceAlyosha: Religion was just what that guy brought up. To say "delusion" where anything is unverifiable/untrue is just stupidity.

I lost my train of thought in my last reply saw this and regained it.

Your deeply religious(my last category), will tend to defy real science. Evolution to health care. They flat out reject it, no matter their educational background, they'd rather cure their baby by letting it get bitten by a sacred amount of cobra's than take it to an evil hospitable. Certain creationists are this bad, and even some less literal religious sects, but just as vehement in not only distrust, but active disbelief in science.


You know one of the big differences between humans and the great apes, cognitively? It's not just how intelligent we are. It's how creative we are.

The two things are not the same. They're two different talents/attributes. On the very low end of the scale they strongly correlate---meaning if you're very low intelligence, you're very low creativity, and vice versa.

As you go up the scale, the correlation diverges rapidly, so that by the time you hit genius level in intelligence or creativity, being a genius in one says absolutely nothing about your ability in the other, beyond that you beat a basic minimum.

But anyway, when you look at great apes, they're real good at copying each other, and every generation or so they'll have a "genius" who thinks of something new. Like the "genius" ape who thought of washing her potatoes in the sea to salt them. The other apes copied her, and now they all do it. A cultural advancement---but one of creativity, not necessarily smarts. It had to occur to her.

A lot of their advances that get carried on through the future of the whole troop, maybe spread to other troops locally, are like that. It had to occur to someone. An advance of creativity, not reasoning.

Psychology has studied creativity a lot. It's still not really well understood. But we know it frequently correlates highly with mental illness. And when it doesn't go along with mental illness, it often goes along with the families who have the genes for mental illness--just sometimes with individuals who aren't sick (like Ada Lovelace).

But all humans are pretty damned creative, compared to great apes.

To be creative, you have to be able to conceive of reality the way it isn't.

I suspect all humans being a little bit nuts may just be part of the price we pay for being able to create and build and develop neat things and think great thoughts and chart new courses for ourselves.

Being a little bit nuts may be the price we pay for being able to even conceive of the question: Where do you see yourself in five years?
 
2012-05-14 09:35:08 AM
There are a few categories they should put back in. Lulz would be had.
 
2012-05-14 12:58:01 PM
It's psuedo-science. At best.
 
2012-05-14 01:43:44 PM
Jixa: dahmers love zombie: I cannot conceive of a single legitimate medical reason for this.


I'm sure GlaxoSmithKline, Pfizer, AstraZeneca and the other pharmaceutical companies could conceive of several billion monetary reasons.

Because everyone is sick and even if you're not, there's a pill for that too.


Yeah. but....
For every BS serotonin drug they come up with, they come up with a legit drug that actually helps people. (citation needed). OK, not sure about the ratio, but they are coming up with new heart meds, diabetes meds, cancer drugs, and the pills that are selling are financing the actual research. So I'm torn.
 
2012-05-14 02:39:55 PM
omeganuepsilon: It's a science, but it's in it's infancy. It's not fake(pseudo), it's limited.

I disagree.

Psychology overwhelmingly lacks the methodological rigor of the physical sciences and science-based medicine. There are a few bright pockets of scientific rigor (which are mostly coming from under the neuroscience banner), but they are by far the exception rather than the rule.

As with chiropractic, it may have some practical value in some specific limited cases, but those cases are far more narrowly constrained than the vast majority of practitioners will admit. And, like chiropractic, the field is rife with quackery and charlatans who do more harm than good. Most damningly, the field at large has done very little to defrock the quacks in it's rank and distance itself from discredited practices.

Definition of Pseudoscience, per Wikipedia:
Pseudoscience is a claim, belief, or practice which is presented as scientific, but does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status.

Pseudoscience is often characterized by the use of vague, exaggerated or unprovable claims, an over-reliance on confirmation rather than rigorous attempts at refutation, a lack of openness to evaluation by other experts, and a general absence of systematic processes to rationally develop theories."


Let's see:
Presented as scientific? Check.
Does not adhere to valid scientific method? Check
Lacks supporting evidence or plausibility? Check
Untestable? Check
Unprovable claims? Check
Over-reliance on confirmation? Check
Lacks rigorous refutation? Check
Lack of openness to evaluation by outside experts? Check

Textbook pseudoscience.
 
2012-05-14 02:59:36 PM
Julie Cochrane: I suspect all humans being a little bit nuts may just be part of the price we pay for being able to create and build and develop neat things and think great thoughts and chart new courses for ourselves.

Certainly. But if we can find the mechanic that allows the mind to latch onto what is highly unlikely, or even impossible, in favor of more obvious simple explanations that do hold true and are demonstrable to be considered truth within scientific standards...

Do we manipulate?

Psychology tries to nudge us into the right direction, but what if we could forcibly place people on the intellectually honest path of thinking? Would we?

That gets to be dangerous ground in today's liberal and warm and cuddly world view.
/rhetorical

I do believe that if education revolved more around critical thinking instead of commuting pure facts to memory, that there would be less of a split society. More progress would be made socially and scientifically, and education would progress as well. It would be a positive cycle, at least until we slide into another limitation.

Religion and philosophical language and precepts allow for a lot of unsound logic, and even disbelief of what's taught in school, from a very early age. Sure, kids can answer the tests, but that does not prove understanding of a concept of an event.

They do not seek to circumvent the ability to rationalize/justify an illogical state, much less teach the proven method of discovering fact. Its glossed over if touched upon at all.

Makes for a lot of discrepancy of "opinions" on what is fact.
 
2012-05-14 03:07:32 PM
clyph: Presented as scientific? Check.
Does not adhere to valid scientific method? Check
Lacks supporting evidence or plausibility? Check
Untestable? Check
Unprovable claims? Check
Over-reliance on confirmation? Check
Lacks rigorous refutation? Check
Lack of openness to evaluation by outside experts? Check

Textbook pseudoscience.


Pavlov got very reliable results. He formulated a theory, demonstrated it multiple ways in multiple species(repeatable with predictable results), even human babies(which is why he was shut down).

He alone un-checks most of what you've checked.
(granted he's listed as a physiologist but the area he worked was also psychology, how the mind functions)

Not textbook pseudo anything.
 
2012-05-14 04:16:56 PM
clyph: omeganuepsilon: It's a science, but it's in it's infancy. It's not fake(pseudo), it's limited.

I disagree.

Psychology overwhelmingly lacks the methodological rigor of the physical sciences and science-based medicine. There are a few bright pockets of scientific rigor (which are mostly coming from under the neuroscience banner), but they are by far the exception rather than the rule.


You are focusing solely on the clinical side of Psychology, and ignoring the social, behavioral, cognitive (though much of this is neuroscience), I/O, quantitative, and many other sides.

As the other guy pointed out, Pavlov got very consistent results, Asch got very consistent results, look at Cialdini's work on interpersonal decision making, or Chomsky's work on language acquisition. These are all very clearly science, and blow your checklist out of the water.

Psychology is about a lot more than mental illness. What you have a problem with is psychiatry. Psychology is about how people do what they do, why they do what they do, how different situations change that, and how to make humans better at what they do. Trying to boil all human actions down to chemical levels in the brain is like trying to boil medicine down to elementary particles not doing what we want them to, or being where we think they should be. It may be technically correct, but it doesn't do anyone any good at that level, and we'll be much better off if we expand our view a little bit, and see those misplaced particles as a gangrenous finger that needs to be chopped off.

Personally, I hate clinical psych, absolutely despise it, but there is a lot of good stuff in the field as a whole.

/Graduated yesterday with a psych degree, so getting a kick, etc.
//gap year with americorp before grad school
 
2012-05-14 04:58:58 PM
vanish57: You are focusing solely on the clinical side of

Imo, it's the repercussions of liberal philosophy. Talking about X without knowing the details of how it works, and more or less, attempting to circumvent actual work to come to a conclusion.(in essence, still trying to prove itself as "valid")

Psychiatrists may be terrible people on the whole, but nothing is innately wrong with psychiatry as a study/method of treatment. There are plenty of success stories, people with real problems, who get a solution with taking drugs. X does indeed help with problem 23. Knowing how and why is science.

On the whole, I find that too many people look at something and make prejudicial remarks about a lot of supposedly "debatable" sciences just because they're pretty far from being reliable. They look at electronics and say, "we've got that, that's a science" and other things that are not up to that pretty crazy standard are simply not a "science" to them. It doesn't meet their personal and arbitrary vision of what science is.

They don't take into account that things like psychology are much more complicated than modern technology and are infinitely harder to study. When it comes to something they cannot fathom, they resort to claims of pseudo-science.

Psychology, Neuroscience, psychiatry, biology, physiology, etc, are all tied together, or sub-branches of each other, by necessity, when studying humans. People don't quite see that, they think it unknowable, answers unattainable, and therefore, not science. A pure example of bad philosophy that's limited humanity throughout history.

Philosophy, in concept wass a good thing, but I do take terrible issue with it because it's been warped and deluded over the centuries, it's rules, it's labels, it's procedure, created as they go along and are rigid and irrelevant, wonky, or just plain ridiculous, but stumbles upon tiny grains of truth along the way.

It's late blooming ugly ducking of a sibling, science, does a much better job at figuring out how things work.
(there is no innate question of "why", once you make the distinction, and they dislike that you can't assume there is a "why" at because it implies choice/design/outside influence).
Philosophy should leave science alone and stick to poetry and religion(if it actually wants to help advance society/understanding), or at least not contradict and fight against science. It's like a modern agnostic trying to cover all bases so that it's never wrong or culpable, but really has no feeling about anything, except it's own grandness. Largely irrelevant, and pompous.

[disclaimer: Sure, "why" is valid linguistically, as a casual word substitute. "Why are we here?" is an improper question, but rather understood as "How did we come to be here?" If we trace "how" back far enough, we may indeed find a "why", but it is not an implicitly necessary fact. Believing that there is a "why" is akin to religious fanaticism.

The distinction is required, because in a technical discussion, specificity and logic over rule casual/common language fads/drift that do nothing but muddy the waters(a special talent of philosophy)]
 
2012-05-15 01:27:03 AM
Julie Cochrane: Being a little bit nuts may be the price we pay for being able to even conceive of the question: Where do you see yourself in five years?

I don't know about that guy, but I know where I'll be.
Without waxing philosophical*ick*, in the nuthouse.

I could swear I saw more posts here. Stuff's disappearing in front of my eyes practically.
[sigh]
Devil's in the details though. It's a crappy medium to hold some conversations.
Will see you around.
 
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